Venous thromboembolism after urological surgery

Mark D. Tyson, Erik P Castle, Mitchell R Humphreys, Paul E. Andrews

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Purpose We determined the rates of deep venous thromboembolism and pulmonary embolism after common urological procedures in the United States. Materials and Methods The NSQIP database was used to identify common urological procedures performed between January 1, 2005 and December 31, 2011. A total of 82,808 patients were included in the study. Results Overall 633 (0.76% of 82,808 subjects) deep venous thromboses occurred within 30 days of surgery in this cohort of patients treated with common urological procedures. Among procedures performed at least 500 times the rates of deep venous thrombosis were highest for cystectomy/urinary diversion (3.96% [71/1,792]), partial cystectomy (2.35% [17/722]) and open radical nephrectomy (1.67% [45/2,702]). The rates of deep venous thrombosis were lowest in patients undergoing laparoscopic colpopexy (0.00% [0/707]), placement of a female sling (0.08% [9/10,648]) and hydrocelectomy/spermatocelectomy/varicocelectomy (0.13% [3/2,333]). A total of 349 (0.42%) pulmonary embolisms occurred in this cohort, with cystectomy/urinary diversion having the highest rate overall (2.85% [51/1,792]). Multivariate logistic regression revealed that age greater than 60 years, functional status, history of disseminated cancer, congestive heart failure, anesthesia time greater than 120 minutes and chronic steroid use were independently associated with the formation of deep venous thrombosis/pulmonary embolism. A limitation of the study is that no data were available on thromboembolic prophylaxis. Conclusions While deep venous thrombosis and pulmonary embolism are uncommon after urological surgery, this study is the first to our knowledge to provide a comprehensive comparison of deep venous thrombosis/pulmonary embolism rates across a full spectrum of various urological procedures in American patients. This study should give the reader a better understanding of the exact risk faced by the patient when undergoing common urological procedures.

Original languageEnglish (US)
Pages (from-to)793-797
Number of pages5
JournalJournal of Urology
Volume192
Issue number3
DOIs
StatePublished - 2014

Fingerprint

Venous Thromboembolism
Venous Thrombosis
Pulmonary Embolism
Cystectomy
Urinary Diversion
Nephrectomy
Ambulatory Surgical Procedures
Anesthesia
Heart Failure
Logistic Models
Steroids
Databases
Neoplasms

Keywords

  • pulmonary embolism
  • urological surgical procedures
  • venous thrombosis

ASJC Scopus subject areas

  • Urology

Cite this

Venous thromboembolism after urological surgery. / Tyson, Mark D.; Castle, Erik P; Humphreys, Mitchell R; Andrews, Paul E.

In: Journal of Urology, Vol. 192, No. 3, 2014, p. 793-797.

Research output: Contribution to journalArticle

Tyson, Mark D. ; Castle, Erik P ; Humphreys, Mitchell R ; Andrews, Paul E. / Venous thromboembolism after urological surgery. In: Journal of Urology. 2014 ; Vol. 192, No. 3. pp. 793-797.
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abstract = "Purpose We determined the rates of deep venous thromboembolism and pulmonary embolism after common urological procedures in the United States. Materials and Methods The NSQIP database was used to identify common urological procedures performed between January 1, 2005 and December 31, 2011. A total of 82,808 patients were included in the study. Results Overall 633 (0.76{\%} of 82,808 subjects) deep venous thromboses occurred within 30 days of surgery in this cohort of patients treated with common urological procedures. Among procedures performed at least 500 times the rates of deep venous thrombosis were highest for cystectomy/urinary diversion (3.96{\%} [71/1,792]), partial cystectomy (2.35{\%} [17/722]) and open radical nephrectomy (1.67{\%} [45/2,702]). The rates of deep venous thrombosis were lowest in patients undergoing laparoscopic colpopexy (0.00{\%} [0/707]), placement of a female sling (0.08{\%} [9/10,648]) and hydrocelectomy/spermatocelectomy/varicocelectomy (0.13{\%} [3/2,333]). A total of 349 (0.42{\%}) pulmonary embolisms occurred in this cohort, with cystectomy/urinary diversion having the highest rate overall (2.85{\%} [51/1,792]). Multivariate logistic regression revealed that age greater than 60 years, functional status, history of disseminated cancer, congestive heart failure, anesthesia time greater than 120 minutes and chronic steroid use were independently associated with the formation of deep venous thrombosis/pulmonary embolism. A limitation of the study is that no data were available on thromboembolic prophylaxis. Conclusions While deep venous thrombosis and pulmonary embolism are uncommon after urological surgery, this study is the first to our knowledge to provide a comprehensive comparison of deep venous thrombosis/pulmonary embolism rates across a full spectrum of various urological procedures in American patients. This study should give the reader a better understanding of the exact risk faced by the patient when undergoing common urological procedures.",
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AB - Purpose We determined the rates of deep venous thromboembolism and pulmonary embolism after common urological procedures in the United States. Materials and Methods The NSQIP database was used to identify common urological procedures performed between January 1, 2005 and December 31, 2011. A total of 82,808 patients were included in the study. Results Overall 633 (0.76% of 82,808 subjects) deep venous thromboses occurred within 30 days of surgery in this cohort of patients treated with common urological procedures. Among procedures performed at least 500 times the rates of deep venous thrombosis were highest for cystectomy/urinary diversion (3.96% [71/1,792]), partial cystectomy (2.35% [17/722]) and open radical nephrectomy (1.67% [45/2,702]). The rates of deep venous thrombosis were lowest in patients undergoing laparoscopic colpopexy (0.00% [0/707]), placement of a female sling (0.08% [9/10,648]) and hydrocelectomy/spermatocelectomy/varicocelectomy (0.13% [3/2,333]). A total of 349 (0.42%) pulmonary embolisms occurred in this cohort, with cystectomy/urinary diversion having the highest rate overall (2.85% [51/1,792]). Multivariate logistic regression revealed that age greater than 60 years, functional status, history of disseminated cancer, congestive heart failure, anesthesia time greater than 120 minutes and chronic steroid use were independently associated with the formation of deep venous thrombosis/pulmonary embolism. A limitation of the study is that no data were available on thromboembolic prophylaxis. Conclusions While deep venous thrombosis and pulmonary embolism are uncommon after urological surgery, this study is the first to our knowledge to provide a comprehensive comparison of deep venous thrombosis/pulmonary embolism rates across a full spectrum of various urological procedures in American patients. This study should give the reader a better understanding of the exact risk faced by the patient when undergoing common urological procedures.

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